Veneers – Common questions and misconceptions

With so many options and much information available, patients often don’t know what to believe when it comes to veneers! This blog gives some insight into some of the common questions our team get asked a must read for anyone looking into the treatment.

Do you have to drill my teeth down to ‘Pegs’ before I can have Veneers?

This is a common area of concern for anyone considering cosmetic dental treatment. Cosmetic dentistry is optional and is often opted for by people with very strong healthy teeth so of course, maintaining healthy strong teeth is fundamental!

There is a common misconception that dentists have to drill the teeth down to ‘pegs’ to prepare the teeth for porcelain veneers. This method is called ‘crowning’ the teeth and yes, is used as a cosmetic option by some dentists.
Ideally, crowning is a method that is used, mainly for the back ‘biting’ teeth when they require strengthening or rebuilding after large fillings have broken down or when cracks and breaks occur. Crowns are also used on front teeth in situations where the teeth are heavily filled or broken down, however if a tooth is strong and healthy we prefer to use a ‘veneer’ to cosmetically enhance a tooth.

A crown removes ALL of the tooth enamel, leaving space to replace the removed enamel with strong porcelain. Cosmetically crowns can look very nice, however they can be over kill and remove far too much natural tooth, when we are just looking for a cosmetic enhancement.

A ‘veneer’ is a very thin piece of porcelain, created to cover only the front (smile) surface if the tooth and gently wrap under the tooth and slightly around the edges, this preserves as much of the natural tooth underneath as we can and gives beautiful, natural aesthetics. When the natural teeth are well aligned, we can create ‘ultra-thin’ porcelain veneers at around 0.3mm thick – meaning we only must take 0.3mm of the tooth enamel away to make space.

What if my teeth are not well aligned?

Unfortunately, when the natural teeth are crooked we are usually required to remove additional tooth enamel to achieve alignment with porcelain, however, it is still rarely necessary to use a ‘crown’ technique.

When teeth are crooked there is usually a tooth or many teeth that the patient feels are positioned ‘too far forward’. This is often true, however we usually find that the crookedness is a combination of teeth being ‘too far forward’ AND too far ‘inward’ creating dark areas or narrowness toward the front and back of the smile. If we work on increasing the circumference of the arch we can be more conservative with the amount of natural tooth that is removed. When adding to the teeth, it is very important that a thorough facial analysis is always carried out to prevent creating new teeth that look too ‘bulky’ or too large. There is a very fine line! But very careful planning and ALWAYS trialling the new smile first allows us to achieve the desired results.

There is always a biological limit when fixing teeth with porcelain, so if we are presented with a case that we feel would benefit from the alternative of Orthodontic work instead of veneers or prior to veneers then this is an option we will always discuss.

What is the difference between Lumineers or Glamsmile and Veneers?

Patient’s often ask us about ‘Lumineers’ or ‘Glamsmile, a type of veneer which is advertised as a ‘zero-preparation’ veneer. They are made by a laboratory in the USA called DenMat and only require a minimal number of visits to achieve the desired result, unfortunately, with limited opportunity for design input from the dentist and no chance to trial. Lower pricing is generally seen as one of the benefits to Lumineers or Glamsmile over handcrafted veneers.

There are some technical advantages with Lumineers – they are fast and the main attraction or main claim is that due to the ‘zero preparation’ they are entirely reversible. This is not entirely true. Although there are no drills involved with preparing the tooth for a Lumineer, we do have to ‘etch’ or roughen the surface of the tooth to prepare the surface for bonding. This etching process will permanently roughen the enamel and although the tooth isn’t drilled, the tooth will never be the same again.

Instead we chose to use minimum preparation Veneers which still preserves as much tooth enamel as we can AND each case is tailor made and handcrafted by the best ceramists around – we feel these results just cannot be achieved by sending models to DenMat USA.

Our practice has been an official provider of ‘Lumineers’ for many years now, yet we have only completed a handful of cases. Our team feel the best cosmetic result can only be achieved by planning each case in house with our own highly skilled technicians. We believe that beautiful cosmetics require time, thorough planning, revision throughout a trial phase and carefully selected ceramists. Some things just shouldn’t be rushed!

Joanne Hall